Pre Operative Cataract Information
Pre Operative information for Cataract Surgery:
The waitlist for surgery is at NRGH (Nanaimo General Regional Hospital). In some cases the waits can be shorter depending on the urgency and nature of the cataract. Each patient is evaluated individually. Once you are place on the cataract waitlist, pre-operative measurements are scheduled at Dr. Piemontesi's office. On the day of the pre-operative measurements, cataract surgery and lens options are discussed, as well as spectacle requirements after surgery.
You have been supplied with a cataract surgery package, which contains:
A prescription for eye drops
A prescription for Acetazolamide (not to be taken by patients with a supha allery)
An outpatient form to be completed and taken to the hospital on the day of the surgery
A map to the hospital
A pre-operative medical form to be completed by your family doctor, once a surgery date has been given.
Approximately one month notification will be given to prepare for the upcoming cataract surgery. You'll receive a phone call from Dr. Piemontesi's office the day before surgery to find out what time to be at the hospital.
Once your surgery date known an appointment needs to be scheduled with your family doctor for a pre-operative medical. The family doctor may order blood work and determines whether an ECG is required. These reports are sent to Dr. Piemontesi's office and the hosptial.
Blood Thinners and Other Medications:
Discontinue Aspirin 5 days prior to surgery
Patients who take blood thinners (Warfarin, Plavix, or Pradaxa), must consult with their family doctor prior to stopping any of theses medications. You may be placed on alternative medication if your are at increased risk.
Patients on Warfarin or Coumadin are required to have an INR the day prior to surgery. A copy should be sent to Dr. Piemontesi's office.
Discontinue all prostate medications 14 days prior to cataract surgery unless instructed otherwise
Diabetic patients are advised to take their diabetic medication(s) as usual.
Unless otherwise instructed by Dr. Piemontesi continue all regular medications including blood thinners.
The night before surgery try to have an early the night and read through all the pre-operative instructions carefully.
The prescriptions fore the eye drops and 3 tablets of Acetazolomide should be filled once you have a surgery date. Patients with a sulpha allergy are not to take the Acetazolomide.
Instructions for Eye drops and Acetazolamide:
PATIENTS WHO TAKE GLAUCOMA MEDICATIONS ARE TO CONTINUE WITH THE MEDICATION, unless instructed otherwise by Dr. Piemontesi.
Please note, each drop should be taken 5-10 minutes apart in order to allow full absorption of each drop.
Instill each eye drop into the lower lid pouch and close the eye for 1 minute afterwards
Patients who struggle to instill their own eye drops are advised to obtain assistance.
Drops Prior to Surgery
Prolensa 1 drop 1 time in the morning to the operative eye 2 days before surgery.
Vigamox 1 drop 4 times a day to the operative eye 2 days before surgery
Lotemax 1 drop 4 times a day to the operative eye 2 days before surgery
After surgery
Acetazolamide 250 mg 3 tablets are to taken orally as follows:
1 tablet at the hospital at the hospital after surgery
1 tablet at bedtime following the surgery
1 tablet at breakfast, the morning after the surgery.
Acetazolamide is used to help prevent pressure spikes in all patients, but is particularly important for glaucoma patients.
Drops:
Restart all eye drops 2-3 hours after surgery, unless instructed by Dr. Piemontesi at the hospital. Once you restart the drops they are instilled every 4 hours while awake.
Carefully lift the eye shield to instill drops and place the shield back over the eye. (The eye shield must kept on at all times until you see Dr. Piemontesi the next day)
Take all three eye drops until all the bottle are FINISHED. The eye drops should last between 1-4 weeks.
Post operative eye drops only need to be used during waking hours.
